- Telemedicine use rose sharply during the pandemic, but remote patient monitoring did not follow.
- Wearables can improve health outcomes during pandemics.
- Here’s how to use data from wearables to improve public health.
Forecasters have been forecasting the rise of telemedicine for years. However, it took a pandemic for people to embrace it. Some studies estimate that telemedicine accounted for 20% of all medical visits in 2020 and was carried out by three out of four US hospitals.
You might assume that the meteoric growth of the field would have coincided with an increase in the use of remote health monitoring technology.
But no. For example, a recent study, conducted in part by the professional group I lead at the Digital Medicine Society (DiMe), found that only 11% of virtual visits during the pandemic were remote monitoring.
And yet the ability is there: over the past six months, Amazon and Apple have introduced sophisticated fitness trackers for measuring body temperature and blood oxygen levels. However, healthcare professionals have been cautious about using these new tools, and understandably so, as they lack a clear understanding of how to use them safely, effectively and ethically.
Which of the following types of telemedicine do you use for clinical care?
Only 11% of telemedicine encounters used remote patient monitoring.
Image: COVID-19 Healthcare Coalition
To address those concerns, in September my DiMe team helped launch The Playbook, a comprehensive guide that supports the successful development and adoption of digital health interventions for patient care, clinical research, and public health.
Created with support from FDA colleagues and participants from over 200 organizations worldwide, the playbook is an open access resource that has been downloaded thousands of times and used by a variety of partners, including pharmaceutical giants such as Merck and Pfizer.
Human-generated data, as opposed to clinics, opens the door to a future where a successful healthcare system is defined by the health of the individual, not the treatment of their illnesses.
– Jennifer Goldsack
Shortly after the success of The Playbook, our team was excited to join the forum on its new platform focused on consumer use of wearables to improve health outcomes during pandemics. This initiative welcomes the CDC, Facebook, Google, the Mayo Clinic and the World Health Organization in their efforts.
With The Playbook providing the basic roadmap, the collaboration with The Forum aims to use this map to take some actual travel in the form of pilot studies and, eventually, full clinical trials.
And we have a very specific goal in mind: to use best practice under the pressure of the greatest public health crisis of our lives.
Reinterpreting healthcare in the digital age
Defining approaches to using data generated by humans as opposed to clinics opens the door to a future where a successful healthcare system is defined by the health of the individual, not the treatment of their illnesses.
This approach paves the way to ensuring that people in need of care are getting the right guy, in the right place, at the right time.
So what is necessary for success? What does it mean to take the “right” approach to using wearables data to improve public health?
Such data should not be published without restriction as it poses a threat to user privacy. Malicious actors can triangulate something as simple as step count to re-identify people based on their wearables data.
In addition, the potential harm associated with this data has increased rapidly as technologies have emerged that can gather information about our heart, sleep, lungs, and even our perception.
Earning public trust is critical. It follows that respecting the preferences of individuals and prioritizing their safety must be the basis of our work. This means establishing systems of governance that provide health authorities and other authorized users with secure, aggregated, and anonymous insights into the health of individuals and populations.
Second, the principles of justice and justice require that the burden and benefits of using fitness trackers be evenly distributed. There is growing evidence that wearables with optical sensors do not work equally well on different skin tones.
In this area, as elsewhere, the digital divide is wide: many people either lack access to these technologies, the data plans necessary to make them useful, and / or the digital literacy to use wearables successfully.
In a world where health disparities, both within and within nations, are widening, we must take deliberate action to ensure that these technologies improve health care for everyone, not just the privileged few.
Third, the lack of standards limits the usefulness of fitness tracker data. Even simple health data like heart rate cannot be easily compared across platforms. When one wearable measures heart rate as the number of beats per 10 seconds and another reports the “instant” heart rate after each beat, it is impossible to compare and share data without adding additional layers of software.
It is therefore important that key stakeholders come together to develop standards that will enable this data to be really useful for powering healthcare.
How standards make data useful
With The Playbook, we offer a common framework for companies developing sensor-generated health monitoring tools. With all its potential, it is by no means a given that these technologies will improve results equally. Therefore, we need well-informed, deliberate efforts to use new tools ethically and fairly.
The forum’s initiative is designed to show – and not just tell – the global community what it takes to put this into practice.
We are at an important point where high quality consumer technology has become widely available and computing capabilities have emerged that enable massive amounts of data to be ingested and made sense of.
The pandemic has only fueled a shared commitment to reinventing our approach to improving health and healthcare.
It is up to each of us to ensure that we are using these technologies and the data they generate to aid, rather than hinder, progress toward better health. For each.